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Nurse anaesthetist's interactions and assessment of children's anxiety
Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
2012 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Forty to sixty percent of all children having surgery experience preoperative anxiety. Preoperative anxiety is a risk factor for negative behavioural changes postoperative. It is of importance to find strategies in the interaction with the child to reduce anxiety. The overall aim was to describe CRNA's interaction with the child in relation to anxiety during anaesthesia induction and to describe the translation process of m-YPAS into Swedish and the testing of the psychometric properties in a Swedish context. In paper I an explorative qualitative approach with CIT was used and 32 CRNAs were interviewed. Experiences described were about the organisation which included effect of information, teamwork and time. Other experiences were grouped around interrelations such as, communication, meeting both anxious and calm children and experiences of use of physical restraint. Actions taken to reduce anxiety were optimizing the situation, as acting according to the situation, it could mean altering routines, though always without jeopardizing the safety of the child, preparing ahead and using distraction. Creating interpersonal interaction such as, creating contact, participation and using collaboration with the child, parents and colleagues. In paper II m-YPAS was translated into Swedish using cross cultural back translation. The psychometric properties of m-YPAS were tested in two phases. In phase I 52 children were assessed in real time by two SRNAs and one CRNA using m-YPAS and NAS. In phase II 98 video films of children were assessed by experienced CRNAs in the same way as in phase I. The psychometric properties of m-YPAS were good. Conclusion: In the interaction between CRNAs and the child, being flexible and sensitive to the child, taking the role of the child, and acting according to the need of the child were cornerstones in reducing preoperative anxiety and avoiding use of physical restraint. The m-YPAS can be used as an educational tool to enhance the anaesthetist's ability to interpret the child's anxiety. The m-YPAS is a valid and reliable assessment instrument to examine the efficiency of interventions and compare the result of research between cultures.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences , 2012. , 72 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 32
Keyword [en]
Preoperative anxiety, child, nurse anaesthetist, anxiety assessment
National Category
Nursing Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:hj:diva-19527ISBN: 9789185835317 (print)OAI: oai:DiVA.org:hj-19527DiVA: diva2:556634
Available from: 2012-09-25 Created: 2012-09-25 Last updated: 2013-12-16Bibliographically approved
List of papers
1. Nurse anaesthetists' experiences with pre-operative anxiety
Open this publication in new window or tab >>Nurse anaesthetists' experiences with pre-operative anxiety
2013 (English)In: Nursing Children and Young People, ISSN 2046-2336, Vol. 25, no 1, 28-34 p.Article in journal (Refereed) Published
Abstract [en]

Aims To explore nurse anaesthetists’ experiences and actions when administering and caring for children requiring anaesthesia.

Method A qualitative design employing critical incident technique was used. Interviews were carried out with a purposeful sample of nurse anaesthetists (n=32). The nurse anaesthetists’ experiences were grouped into two main areas: organisation focused and interrelational focused. Actions were grouped into two main areas: optimising the situation and creating interpersonal interaction.

Findings The categories and subcategories of the nurses’ experiences appeared to influence the outcome for the child. The nurse anaesthetists’ first priority was to create an optimal environment and increase sensitivity in their interactions with the child.

Conclusion Sensitivity to the child and flexibility in altering actions are key strategies to avoid physical restraint.

Keyword
Anaesthesia, children’s surgery, nurse anaesthetists, pre-operative anxiety, peri-operative nursing
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-22671 (URN)10.7748/ncyp2013.02.25.1.28.s9537 (DOI)
Available from: 2013-12-12 Created: 2013-12-12 Last updated: 2017-03-28Bibliographically approved
2. Reliability and validity of the Swedish version of the modified Yale Preoperative Anxiety Scale
Open this publication in new window or tab >>Reliability and validity of the Swedish version of the modified Yale Preoperative Anxiety Scale
2012 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 56, no 4, 491-497 p.Article in journal (Refereed) Published
Abstract [en]

Background:

The modified Yale Preoperative Anxiety Scale (m-YPAS) is an observational behavioral checklist that has been widely used as an indicator of pre-operative anxiety in children. The present study describes the translation process of m-YPAS into Swedish and the testing of its reliability and validity when used with Swedish children.

Methods:

The questionnaire was translated using standard forward-back-forward translation technique. The validation process was divided into two phases: a pilot study with 61 children as a first version and a test of a final version with 102 children.

Results:

The reliability tested with Cronbach's alpha was acceptable to good. Interrater reliability analyzed with weighted kappa was acceptable to good with Students Registered Nurse Anesthetists and Certified Registered Nurse Anesthetist (CRNA) as evaluators (phase 1) and good to excellent with CRNA's very experienced in child anesthesia (phase 2). Both concurrent and constructed validity could be demonstrated.

Conclusion:

This validation study of the Swedish version of the m-YPAS shows good consistency, interrater validity, and construct validity when used by experienced assessors.

National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-19525 (URN)10.1111/j.1399-6576.2011.02587.x (DOI)
Available from: 2012-09-25 Created: 2012-09-25 Last updated: 2017-12-07Bibliographically approved

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